Efeito da suplementação com ácidos graxos n-3 nas subpopulações de linfócitos T, citocinas pró-inflamatórias e prostaglandina E2 em mulheres recém-diagnosticadas com câncer de mama

Abstract

Introduction: There is evidence that breast cancer patients have impaired immune function, which can promote cancer progression. Chronic inflammation is involved in all stages of carcinogenesis. Studies have shown that n-3 polyunsaturated fatty acids eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids have immunomodulatory and anti-inflammatory properties and are useful in the prevention and treatment of various diseases, including cancer. In this context, this study aimed to investigate in patients with newly diagnosed breast cancer the effects of fish oil supplementation in lymphocytes subpopulation, proinflammatory cytokines, C-reactive protein (CRP) and prostaglandin E 2. Methodology: A randomized, placebo controlled, double-blind clinical trial was conducted in patients diagnosed with breast cancer, divided into two groups (fish oil group-GO and placebo group-GP). The GO patients received 2 g/ day of fish oil concentrate containing 1.8 g of n-3 fatty acids. The placebo group received two capsules/day of 1 g of mineral oil with similar appearance to fish oil. All patients were supplemented for four weeks during the period prior to surgical treatment. Before and at the end of supplementation, we collected anthropometric, body composition and dietary intake data and blood samples for lymphocyte phenotyping, laboratory tests (fasting glucose, serum albumin, lipid profile), serum fatty acids analysis and inflammatory markers (IL-1β, IL-6, TNF-α, CRP and prostaglandin E2). Statistical analysis was performed using parametric and nonparametric tests to compare the results of both groups. Results: GO consisted of 18 patients and the GP 19. At baseline no significant differences were observed between the groups in terms of socioeconomic, anthropometric and clinicopathological parameters. Most of the patients had infiltrating ductal carcinoma and 55.6% and 57.9% of GO and GP, respectively, had negative HER2 tumor. After the intervention there was a significant increase in the amount of EPA (p = 0.004), DHA (p = 0.007) and the total of n3 fatty acids (p = 0.004) in plasma phospholipid of the GO patients. There was a reduction in the n6/ n3 ratio (p = 0.002). In GP patients there was a reduction in the percentage of peripheral blood CD4+ T lymphocytes counts and increased plasma C-reactive protein concentration. In GO patients The proportion of peripheral blood CD4 + T lymphocytes and serum of CRP levels were maintained. There were no significant changes in serum levels of proinflammatory cytokines and prostaglandin E 2. Conclusion: Supplementation of treatment naïve breast cancer patients with 1.8 g/ day of n-3 fatty acids for 4 weeks caused a significant change in the composition of plasma fatty acids, kept the frequency of CD4+ T cells and serum CRP, suggestive of a beneficial effect of the supplement on patient's immune system.